Individual
CHERYL A TILLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4239
(704) 384-5636
Mailing address
PO BOX 601549, CHARLOTTE, NC 28260-1549
(704) 384-4239
(704) 384-5636
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
050634
NC
367500000X
Certified Registered Nurse Anesthetist
50634
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051440
—
NC
05
—
NAN535
—
SC
Enumeration date
05/25/2006
Last updated
08/09/2023
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